What to Do When the Diagnosis Is Cancer

It is not uncommon for a woman to hear the word "cancer" and then to completely block out anything the doctor may say after that. No woman can ever be truly prepared to hear that she has cancer.

No matter what type of breast cancer you have, the effect it has on you depends on a number of factors, including your general health. But one of the most important things you can do for yourself is to find others who have already gone through the anxiety of breast cancer to help you through the fear and worry. Now is not the time to withdraw. Learn all you can about breast cancer - knowledge is power.

Understanding the stages of breast cancer

Breast cancer usually is diagnosed as falling into one of five stages. How your cancer is staged and your treatment choices will depend on:

• How small or large your tumor's size is and where it is found in your breast



• If cancer is found in the lymph nodes in your armpit



• If cancer is found in other parts of your body

Here are some terms sometimes used to describe cancer:

• Malignant: the biopsy revealed the presence of cancer cells



• In situ or noninvasive: a very early cancer or precancer that has not spread beyond the breast



• Invasive: cancer has spread to surrounding tissue in the breast and may have spread to the lymph nodes in the armpit or to other parts of the body



• Metastasized: the cancer has spread to other parts of the body, such as the bones, lungs, liver or brain

Staging of breast cancer

Stage 0

Very early breast cancer or pre-invasive cancer that has not spread within or outside the breast.

Stage I

Tumor smaller than 2 centimeters (cm) (1 inch). No cancer is found in lymph nodes in the armpit, or outside the breast.

Stage II

Tumor smaller than 2 cm (1 inch). Cancer is found in the lymph nodes in the armpit.

or

Tumor between 2 cm and 5 cm (1 and 2 inches). Cancer may or may not be found in the lymph nodes in the armpit.

or

Tumor larger than 5 cm (2 inches). Cancer is not found in the lymph nodes in the armpit.

Stage III

Tumor smaller than 5 cm (2 inches), with cancer also in the lymph nodes that are stuck together.

or

Tumor larger than 5 cm (2 inches) or cancer is attached to other parts of the breast area including the chest wall, ribs and muscles.

or

Inflammatory breast cancer. In this rare type of cancer, the skin of the breast is red and swollen.

Stage IV

Tumor has spread to other parts of the body, such as the bones, lungs, liver or brain.

Tumor Sizes

One inch equals 2.5 cm

Prognosis

Once your doctor has determined the type and stage of breast cancer, your chance of recovery will depend on many factors, including:

• The type and stage of cancer



• How fast and how aggressively the cancer is growing



• How much the breast cancer cells depend on female hormones for growth, measured by hormone receptor tests; tumors that are hormone-dependent (estrogen/progesterone receptor positive) can be treated by hormonal therapy



• Your age and menopausal status



• Your general state of health



• Your mental health and ability to cope with problems

It will be difficult to accept your diagnosis at first, but over time, that may change. A positive attitude and the support of friends and family will not only help you through this ordeal, but may even contribute to your recovery, experts say.

Making decisions

Treatments for breast cancer vary, depending on an individual's situation. In the past, doctors used to perform biopsies and remove breasts all in the same operation. This rarely happens today. Women need time to absorb biopsy results, learn about their options and perhaps get a second opinion. The advantage of a FNA (fine needle aspiration) gives the patient time to assess her surgical options.

Gone are the days when doctors firmly told patients what was best. Today, patients bear more and more responsibility for speaking with a variety of medical experts, gathering as much information as possible and choosing from several treatment options.

When your doctor tells you that you have breast cancer, you feel overwhelmed with emotions and miss important information. Be sure to bring someone with you and a tape recorder so you can review what your doctor has told you about your disease.

Also, be sure to find others who have already gone through the anxiety of breast cancer to help you through the fear and worry. Now is not the time to withdraw.

Related Articles Treatment Options The Road to Wholeness If You're Concerned About Breast Cancer Is That Lump Breast Cancer? Detecting Breast Lumps Who Gets Breast Cancer? What Every Woman Needs to Know

External Sources Understanding Breast Cancer Treatment: A Guide for Patients, National Institutes of Health, National Cancer Institute. Understanding Breast Changes, National Institutes of Health, National Cancer Institute. A Woman's Guide to Breast Cancer Diagnosis and Treatment, California Department of Health Services. Dollinger M, Rosenbaum, EH, Tempero M., et al. Everyone's Guide to Cancer Therapy, Fourth Edition, Kansas City, Missouri: Andrews McMeel Publishing, 2002. Rosenbaum, EH, Rosenbaum, I, Everyone's Guide to Supportive Cancer Care, Fourth Edition, Kansas City, Missouri: Andrews McMeel Publishing, 2005.

This article was reviewed and updated June 2007.

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